Now you are just making things up. Biologic products are much more difficult and expensive to manufacturer than small molecule products (where prices in the US usually drop close to the production cost once Loss of Exclusivity hits). There is no 9900% Markup for Complex biologic products.

You do know that there are many different kinds of insulin product right? You can't put short acting/rapid acting insulin in same category as long acting insulins. Nor can you equate human insulins with insulin Analogs which are quite difficult to produce. Do you even know what biosimilars are?

Looking at "List prices" for Pharmaceutical products is usually not a useful practice. Most brand-name drugs in the US are discounted by around 50% to PBMs /insurers and some of the most widely used insulin products are discounted in excess of 70%. Of course Bernie Sanders just likes to ignore this.

First/best in class drugs do make a lot of money in the US, but "Me-to" drugs and "Not best in class" don't typically make much money. What also seems to not be understood is how much Pharma companies rebate their drugs and how much prices drop once Loss of Exclusivity hits. 1/

The fact that some societies have government funded healthcare does not mean that they don't make decisions around what to fund/not fund. Many of the most innovative Oncology drugs available in the US are not available in the UK because their QUALITY adjusted life year contributions are low.

At the same time, we want the private sector to bare the risk of development of new therapies (i.e., invest at risk up-front to then recover the money if successful). What therapies society should pay for is an important consideration. There are already other less effective HIV therapies out there

These drugs are usually extremely expensive to develop and involve advance science. A high percentage of drugs fail during various stages of development and Biotech companies need to be able to recover these costs on the breakthrough drugs they develop. 1/

And a new ford F series (the top selling car in America) ranges in price between 44K to 79K. Why should society put a greater values on a new Car than on a drug that prevents HIV? Seems to me that the societal value of a drug that prevents HIV is/should be higher than a new Ford F series vehicle.

Critiques of vaccines ignore good science that largely is settled. The science regarding the use of Hormone therapies for Gender dysphoria is largely un-settled and most US guidelines rely on observational studies and seem to be driven driven by political pressures.

Reporters /journalists do usa disfavor is they blindly treat consensus based & evidence-based guidelines the same. Journalists should discuss the evidence medical associations use to inform guidelines. Evidence based guidelines should drive public policy. Consensus based not nearly as much.

There is a big difference between "evidence- based" guidelines and "consensus-based guidelines". Treatment guidelines in areas like Cardiology, Diabetes, and Oncology are usually evidence based. Dietary & gender dysphoria guidelines are frequently not. The former is scientific & the latter is not.